Structured, repetitive physical training and teamwork-oriented activities have been studied as complementary therapies for mental health conditions such as post-traumatic stress disorder (PTSD), depression and anxiety. These interventions harness the benefits of physical exercise, social support and mastery experiences to help participants regulate stress, build confidence and improve overall psychological well-being.
In a randomized controlled trial with veterans (n≈84), a group integrative exercise program was compared with an active psychoeducation class. Both groups experienced significant reductions in clinician-rated PTSD severity (CAPS-5) (integrative exercise: mean change −8.2, SD 9.9, p<.001; psychoeducation: −7.8, SD 2.0, p<.001), with no difference between programs on the primary quality-of-life outcome. Higher attendance predicted larger improvements in PTSD and psychological quality of life. A separate trial comparing group integrative exercise to a waitlist control (n≈47) reported a large effect size on PTSD symptoms (Cohen’s d≈0.90) and moderate gains in psychological quality of life.
A pilot study (n≈30) evaluating angling, equine care or archery/falconry sessions for veterans with PTSD found significant reductions across PTSD, depression, anxiety and stress after the programs (F(1.48, 40.0)=22.06, p<.001). For angling, the PTSD reduction at two weeks corresponded to a large effect size (d=−1.13, 95 % CI −2.03 to −0.23); 57 % of participants achieved a clinically significant change. Benefits were largely sustained at four months. In a randomized wait-list controlled trial (n≈18), veterans assigned to angling showed a significant Group×Time interaction, with two-thirds achieving reliable improvement within two weeks and sustaining gains at four months
A randomized trial with active-duty service members (n≈96) compared surf therapy to hike therapy over six weeks. Both programs involved structured physical activity and team support. Participants in both groups showed significant improvements over time in depressive symptoms (p<.001), anxiety, negative affect, resilience and social functioning. No differences emerged between the two activities, indicating that multiple forms of structured, team-oriented outdoor activity can be effective.
Syntheses of exercise interventions for PTSD report reductions in PTSD severity as well as in comorbid anxiety and depression. While study quality ranges from low to moderate owing to heterogeneous designs, the overall direction of effect is consistently positive. Dose and adherence appear to moderate outcomes: more frequent sessions and higher attendance yield greater benefits.
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